Comfort Hotel Maebashi Reservation Form

FAX: +81-27-226-7912

2013 International Conferences on AMT-BHI

（Please send this form to us by fax after you complete it.）

Reservation Date:

Check-in Date (Month/Day/Year) Arrival Time 　　　　: 　　　　　 　　

Check-out Date (Month/Day/Year)　　　　　　　　　　 　　　　　　　　　　　　　　　　　　　

☐ Smoking ☐ Non-Smoking　 * Non-Smoking rooms are based on availability.

Room Type / Number of room(s)
1 Guest/room　　☐ Single　 　 　　 room(s)

5,500 (JPY)

7,600 (JPY)

@ The breakfast is free
Payment method　　☐ Cash ☐ Credit Card (Credit Card Company:　　　　 　* e.g.：VISA）
* The above discount prices are only applied to the attendees of 2013 International Conferences on Active Media Technology (AMT) and Brain Informatics health.

* The reservation deadline is September 28, one month before the conference. There is a case to decline in no vacancies.

* This form is not suitable for the applications through travel agents or Internet.

* Above prices include the expense (plus tax) of room and breakfast.

* Check-in could be made after 3:00 p.m., and please check-out before 10:00 a.m.

* Earlier check-in and delayed check-out will lead to other costs.

* The written private information will be used only for the room reservation.

* Contact: Front of Comfort Hotel Maebashi

TEL: +81-27-226-7911

Address: 2-18-14 Omotecho, Maebashi-City, Gunma 371-0024

(15 minutes walk, or 5 minutes by car to the conference hall from the Comfort Hotel Maebashi)

* 3 minute walk from JR Maebashi Station! ! We have English speaking staffs ! !